Validación psicométrica de las escalas OAB-V8 y OAB-V3 para la detección de pacientes con probable vejiga hiperactiva en la población española

Cross-cultural adaptation, reliability, and validity of the Persian version of the overactive bladder questionnaire (OAB-V8)

Background and objectives

Overactive bladder (OAB) is characterized by urinary frequency and is recognized as a disorder. Various tools are available for diagnosing this condition. This study aimed to evaluate the reliability and validity of the Persian version of the 8-item Overactive Bladder Scale (OAB-V8).

Methods

This analytical cross-sectional study was conducted on a sample of 150 OAB patients. The OAB-V8 scale was translated and culturally adapted following established guidelines. Face and content validity were assessed using the Impact Score (IS), Content Validity Index (CVI), and Content Validity Ratio (CVR) indices. Reliability was evaluated by calculating Cronbach's alpha (α) and utilizing the test-retest method (Intra-class correlation coefficients (ICC)). Construct validity was explored through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). All statistical analyses were carried out using SPSS version 24 and AMOS version 24, with a significance level set at 5 %.

Results

The face validity was confirmed, with all items having an IS value greater than 1.5. Content validity was also confirmed, as most items had a Content Validity Index (CVI) higher than 0.79, and the average Content Validity Ratio (CVR) value was 0.96. In the initial phase of Exploratory Factor Analysis (EFA), the sample adequacy and suitability of the exploratory analysis were confirmed (Kaiser-Meyer-Olkin (KMO) test value = 0.784, Bartlett's Test p-value <0.05). Two dimensions explaining 61.87 % of the variance were then extracted. In the Confirmatory Factor Analysis (CFA), the fit indices were deemed acceptable (χ^2/df = 2.006, CFI = 0.96, GFI = 0.95, AGFI = 0.89, TLI = 0.93, RMSEA = 0.08). The reliability was confirmed with an alpha coefficient of 0.81 and an Intraclass Correlation Coefficient (ICC) of 0.98.

Conclusion

The Persian version of the OAB-V8 questionnaire demonstrated good validity and reliability, indicating its suitability for use in Persian-speaking countries.

Validation of the Croatian Version of the 8-Item Overactive Bladder Questionnaire (OAB-V8)

OBJECTIVES

The present study was conducted with the aim to translate, adapt, and validate the 8-item Overactive Bladder Questionnaire (OAB-V8) in Croatia.

METHODS

This study included a total of 58 female patients with OAB and 66 healthy women. The translation to Croatian followed standardized procedure. All eligible participants completed OAB-V8 at inclusion and 2 weeks after to assess test-retest reliability. Cronbach α coefficient was calculated to assess internal consistency.

RESULTS

Our study demonstrated high internal consistency for all items at both visits (Cronbach α between 0.799 and 0.847), with stable internal consistency reliability across items during the 2-week period. However, the exception is the item "waking up at night to urinate," which significantly changed during the 2-week period. Intraclass correlation for OAB-V8 items ranged from 0.810 to 1.0, with Spearman correlations greater than 0.9 for all items (P < 0.01). There were strong significant correlations between frequency of urination during daytime and uncomfortable and sudden urge to urinate, and between nocturia and waking up at night. Discriminative validity showed statistically significant score differences between patients and the control group.

CONCLUSIONS

The Croatian version of the OAB-V8 was successfully translated, adapted, and validated so the questionnaire is now ready for use as a reliable tool for initial screening and assessing patients with OAB in everyday Croatian clinical practice.

Analysis of the Readability of Questionnaires on Symptoms of Pelvic Floor Dysfunctions Adapted to Spanish

Questionnaires are tools of interest in the evaluation of pelvic floor dysfunctions, but their success depends on their readability. Evaluating symptoms associated with such dysfunctions through questionnaires validated in Spanish with adequate readability indices will be useful for subsequent therapeutic work with these patients. The objective of this study is to evaluate the readability of symptomatology questionnaires on pelvic floor dysfunctions adapted to Spanish. This descriptive study included a total of 19 questionnaires, whose readability was analyzed according to four indices: Fernández-Huerta, Szigriszt-Pazos, Inflesz and readability µ (mu). In total, 50% of the questionnaires for fecal incontinence symptoms were found to have inadequate scores in terms of readability, according to the Inflesz index. If we take the readability mu index as a reference, the number of questionnaires that do not meet the minimum readability limit are as follows: 20% in urinary incontinence, 50% in fecal incontinence, 66.6% in sexual function, 100% in general pelvic floor, 25% in overactive bladder and 100% in benign prostatic hyperplasia. Therefore, it is necessary to review and adapt health questionnaires on pelvic floor dysfunctions to improve their readability and ease of understanding by conducting studies with the people who fill out these questionnaires.

Validation of the Arabic linguistic version of the 8-item overactive bladder questionnaire (OAB-V8)

INTRODUCTION AND HYPOTHESIS

This study aimed to translate and validate the 8-item overactive bladder questionnaire (OAB-V8).

METHODS

Utilizing a multistep process, the English version of the OAB-V8 was translated into Arabic by three urologists and one independent translator. It was validated by asking 46 patients with overactive bladder and 58 healthy individuals to complete the questionnaire. Healthy individuals were involved in establishing the discrimination validity. The scores of both groups were compared using the Mann-Whitney test. The reliability of the Arabic version was evaluated utilizing Cronbach's alpha test for internal consistency. Spearman's correlation coefficient (r) was utilized to evaluate the domain structures and the inter-domain associations.

RESULTS

Internal consistency was high (Cronbach's alpha = 0.923). There were good correlations among frequency, urgency, sudden urge to urinate, waking up at night to urinate and uncontrollable urge to urinate. There were weak or no correlations among urge, incontinence and nocturia. For discrimination validity, there were significant changes in all domain scores when comparing patients with ureteric stents and healthy individuals (P < 0.001).

CONCLUSIONS

The Arabic version of the OAB-V8 proved to be a reliable and valid tool, which can be easily utilized to evaluate symptoms in Arabic patients. It is feasible in evaluating quality of life in relation to this disorder, as patients are able to demonstrate their symptoms accurately with the comfort of their first language, Arabic.

[Prevalence and characterization of overactive bladder detected in a population in Madrid with self-administered OAB-V3 questionnaire in Primary Care]

Objetivo

Determinar la prevalencia de síntomas sugestivos de vejiga hiperactiva (VH) en una población española y evaluar su impacto en el bienestar y la productividad laboral de esta población.

Diseño

Estudio transversal.

Emplazamiento

Atención primaria, Madrid, España.

Participantes

Varones y mujeres > 30 años.

Intervenciones

Clasificación con el instrumento abreviado Overactive Bladder Awareness Tool (OAB-V3). Sujetos con puntuación ≥ 3 y una población control similar con puntuación < 3 fueron investigados clínicamente.

Mediciones principales

Anamnesis, exploración física, análisis de orina, ecografía, escala de bienestar general y cuestionarios PPBC, OAB-q y WPAI-SHP.

Resultados

Se cribaron 923 sujetos, 209 (22,6%) de los cuales —35% hombres y 65% mujeres— presentaron probable VH. La distribución por edad aumentó del 11,1% en la cuarta década al 44,4% en la novena década. El coeficiente kappa entre probable VH y diagnóstico definitivo fue de 0,83. El área bajo la curva ROC para el diagnóstico según el cuestionario OAB-V3 y la constatación de molestias percibidas y estrategias de afrontamiento fue del 92%. Los sujetos clasificados por OAB-V3 ≥ 3 tuvieron peor bienestar, mayor puntuación PPBC y peores parámetros en las puntuaciones OAB-q total y transformadas para cada subescala OAB-q (p < 0,0001). Su productividad laboral no se vio afectada (p = 0,14), pero sí la capacidad de realizar actividades cotidianas (p < 0,0001).

Conclusiones

OAB-V3 es un cuestionario simple para el cribado de VH con buena exactitud de predicción en atención primaria y que conlleva implicaciones importantes en la calidad de vida relacionada con la salud.

Comparative study of the B-SAQ, OAB-V8 and OAB-V3 questionnaires as screening tools for overactive bladders in clinical practice

OBJECTIVE

To compare the capacity shown by 3 self-assessment questionnaires validated in Spanish (B-SAQ, OAB-V8 and OAB-V3) for the screening of patients with overactive bladder (OAB) in clinical practice.

MATERIAL AND METHOD

A noninterventional observational study was conducted of men and women older than 30 years evaluated in primary care consultations. The clinical diagnosis of OAB was conducted through a case history review, physical examination, urine analysis, ultrasonography and voiding diary. The presence of coping strategies and discomfort was investigated. The differential diagnosis was established in patients with symptoms not due to OAB. We assessed the correlation between the clinical tests and diagnosis (kappa <.4 poor; .4-.6 moderate; >.6 good; >.8 excellent) and ROC curves to define the capacity to screen the assessed questionnaires.

RESULTS

A total of 411 patients were investigated. OAB was detected in 207 (50.4%) patients, other causes for the lower urinary tract symptoms were detected in 63 (15.3%), and 141 (34.3%) patients had no diagnosis. The voiding diary suggested OAB in 197 (47.9%) patients. The correlation between the clinical diagnosis and the diagnosis based on the voiding diary was .702. The correlation between the clinical diagnosis and B-SAQ, OAB-V8 and OAB-V3 was .59, .673 and .732, respectively. The area under the curve (AUC) was .799 for B-SAQ; .837 for OAB-V8 and .867 for OAB-V3 (OAB-V3 vs. OAB-V8, P=.02; OAB-V3 vs. B-SAQ, P<.0001). The AUC for the voiding diary was .852 (OAB-V3 vs. diary, P=.47).

CONCLUSIONS

OAB-V3 is a simple questionnaire with excellent performance for screening OAB in a specific population and that is superior to the OAB-V8 and B-SAQ. The accuracy of the voiding diary for the same indication is equivalent to that of the OAB-V3 in our setting.

Cultural adaptation to Spanish (Spain) of the "Overactive Bladder - Family Impact Measure (OAB-FIM)" questionnaire

OBJECTIVE

The OAB-FIM was developed as a measure of the impact of an overactive bladder (OAB) on relatives who live with the patient. The objective of this study was conduct a cultural adaptation to Spanish (Spain) of the OAB-FIM questionnaire.

METHODS

The adaptation included a conceptual and linguistic validation phase, as well as a phase for measuring the psychometric properties in 25 relatives [mean age, 63.0 years (SD, 14.3); 44% women] who regularly live with patients with OAB, who are of either sex and 18 years of age or older. We measured conceptual and linguistic equivalence, internal reliability, construct validity and content validity. We assessed the applicability and administration load.

RESULTS

The OAB-FIM was conceptually and linguistically equivalent to the original, maintaining its 6 domains: social, travel, worry, irritability, sleep and sex. The interagreement correctly placed all items in their domain, except for number 10, which was placed more in worry than in irritability, motivates its reformulation. Some 2.95% of the items were missing. The floor and ceiling effects of the items varied, respectively, between 20-28%, and 0-16%. The mean time for completing the questionnaire was 5.2minutes (SD, 2.8), and 24% of the participants required some type of assistance. The α-Cronbach coefficient varied between 0.948-0.839. The correlations with similar scales in the family were moderate-high (0.407-0.753) or small-moderate with those administered to the patient (0.004-0.423).

CONCLUSION

We obtained a Spanish (Spain) version of the OAB-FIM that was conceptually and linguistically equivalent to the original. The questionnaire showed good internal consistency, content and construct validity and applicability.

Impact of daily number of urgency urinary incontinence episodes on overactive bladder patient reported outcomes

OBJECTIVE

To explore the impact of urgency urinary incontinence (UUI) on well-being in non-institutionalized patients with overactive bladder (OAB) in a community sample.

METHODS

A cross-sectional web-based study was conducted in the general population, including males and females, >18 years of age. Patients with probable OAB were identified using a validated algorithm together with a score ≥8 on the OAB-V8 scale. Presence of coping behavior was considered determinant for the clinical diagnosis of OAB. Individual well-being was determined through a battery of patient-reported outcomes (PRO) measurements including assessment of health-related quality of life (EQ-5D), sleep disturbances (MOS Sleep), and life satisfaction (LISAT-8). Patients were grouped according to the number of daily UUI episodes (UUI severity): 0 (dry OAB),1, 2-3, or ≥4. Multivariate analysis to evaluate factors independently affecting quality of life was undertaken.

RESULTS

A total of 396 patients (52.5% women, mean age: 55.3 [11.1] years, OAB-V8 mean score: 14.5 [7.9]) out of 2035 subjects participating from the general population met the criteria for OAB: 203 (51.3%) with 0episodes, 119 (30.1%) with 1, 52 (13.1%) with 2 or 3, and 22 (5.6%) with ≥4 episodes. A statistically significant linear adjusted association was found between number of UUI episodes and PRO scores. Participants with more episodes had poorer health profiles and self-evaluated quality of life, worse life satisfaction, and more sleep disturbances and fewer hours of sleep per night. Number of incontinence episodes was independent factor to affect quality of life using both LISAT-8 and MOS questionnaires.

CONCLUSION

Severity of UUI was significantly associated with poorer individual well-being in subjects with OAB in a community sample in Spain.

[Consensus document on overactive bladder in older patients]

Overactive nladder (OAB) is a clinical entity with a high prevalence in the population, having a high impact on quality of life, especially when it occurs with urge urinary incontinence. It is very important to highlight the low rate of consultation of this condition by the older population. This appears to depend on several factors (educational, cultural, professional), and thus leads to the low percentage of older patients who receive appropriate treatment and, on the other hand, a large percentage of older patients with a significant deterioration in their quality of life. Therefore, Scientific societies and Working Groups propose the early detection of OAB in their documents and clinical guidelines. Its etiology is not well known, but is influenced by cerebrovascular processes and other neurological problems, abnormalities of the detrusor muscle of bladder receptors, and obstructive and inflammatory processes of the lower urinary tract. Its diagnosis is clinical, and in the great majority of the cases it can be possible to establish its diagnosis and etiopathogenic orientation, without the need for complex diagnostic procedures. Currently, there are effective treatments for OAB, and we should decide the most appropriate for each elderly patient, based on their individual characteristics. Based on the main clinical practice guidelines, a progressive treatment is proposed, with the antimuscarinics being the most recommended drug treatment. Therefore, a group of very involved professionals in clinical practice for the elderly, and representing two scientific Societies (Spanish Society of Geriatrics and Gerontology [SEGG], and the Spanish Society of Primary Care Physicians [SEMERGEN]) developed this consensus document with the main objective of establishing practices and valid strategies, focused to simplify the management of this clinical entity in the elderly population, and especially to improve their quality of life. The recommendations presented in this consensus document are the result of a comprehensive review and critical discussion of articles, documents and clinical guidelines on OAB, both nationally and internationally. Are, where possible, levels of evidence and grades of recommendation are included.